| NPI | 1679524227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 52309) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 1565) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2020-08-18 |